Is Hysterectomy for Cervical Cancer Necessary?

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Dear OncoLink "Ask the Experts,"
My sister has been diagnosed with cervical cancer and wasn't offered a hysterectomy. Every time we tell a doctor or nurse about this they seem to be shocked. Is there any reason a person with cervical cancer wouldn't be given a hysterectomy?
Thank you.

Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:

You have asked a very good question. However, you should realize that the
term "cervical cancer" could mean many different things. A patient with
cervical cancer that has spread beyond the cervix (for example, spread to
the tissues next to the cervix, to the vagina, or to the bowel or bladder)
is not considered a candidate for hysterectomy. These patients are better
treated with chemotherapy and radiation. On the other hand, patients with
"carcinoma in situ", or cervical cancer that is only sitting on the surface
of the cervix without invading the tissue of the cervix, may be adequately
treated by a cone biopsy without need for a hysterectomy. This is
particularly true for patients who are young and who desire to retain the
ability to have children in the future.

If you have specific questions, you should address them with your sister's
physician. Treatment of cervical cancer is not limited to hysterectomy, and
is tailored to each individual patient's situation.

Mar 3, 2015 - Radical hysterectomy may provide better survival outcomes compared with radiation in women with early-stage cervical cancer whose tumors are less than 6 cm in diameter, according to a study in the November issue of the American Journal of Obstetrics & Gynecology.